| 3-D radiotherapy plan dose-volume histograms (77295) |
$7,259.28 |
$12,963 |
5.5× |
| Abdomen 2 views (74019) |
$327.04 |
$584 |
3.3× |
| Acute gastrointestinal blood loss imaging (78278) |
$237.44 |
$424 |
0.6× |
| Ankle 2 views (73600) |
$347.76 |
$621 |
4.2× |
| Antegrade urography radiological supvj & interpj (74425) |
$585.76 |
$1,046 |
1.8× |
| Arthrogram elbow (73085) |
$801.36 |
$1,431 |
2.4× |
| Arthrogram hip (73525) |
$756 |
$1,350 |
2.3× |
| Arthrogram shoulder (73040) |
$392.56 |
$701 |
1.2× |
| Arthrogram wrist (73115) |
$644 |
$1,150 |
1.9× |
| Arthrography knee lt (73580) |
$801.36 |
$1,431 |
2.4× |
| Basic radiation dosimetry calculation (77300) |
$788.48 |
$1,408 |
6.1× |
| Bone &/Joint Imaging Limited Area (78300) |
$414.96 |
$741 |
1.1× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$440.16 |
$786 |
1.2× |
| Bone &/joint imaging whole body (78306) |
$997.36 |
$1,781 |
2.6× |
| Bone age studies (77072) |
$278.32 |
$497 |
2.8× |
| Bone Imaging 3 Phase (78315) |
$1,134 |
$2,025 |
3.0× |
| Bone survey complete (77075) |
$724.08 |
$1,293 |
7.2× |
| Brachytx isodose complex (77318) |
$894.32 |
$1,597 |
2.5× |
| Brachytx isodose intermed (77317) |
$809.20 |
$1,445 |
2.3× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$2,429.28 |
$4,338 |
1.8× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$4,623.92 |
$8,257 |
13.9× |
| Cervical spine 2 or 3 views (72040) |
$385.28 |
$688 |
4.6× |
| Chest 1 view (71045) |
$204.40 |
$365 |
2.5× |
| Chest 3 views (71047) |
$399.84 |
$714 |
4.8× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$579.60 |
$1,035 |
3.5× |
| Cisternography Positive Contrast Rs&I (70015) |
$290.64 |
$519 |
0.4× |
| Clavicle complete (73000) |
$422.80 |
$755 |
5.1× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$690.48 |
$1,233 |
6.9× |
| Continuing medical physics consltj pr wk (77336) |
$126.56 |
$226 |
1.0× |
| Contrast Xray Throat/Cerv Esopha - Fl Esophagus Pharynx (74210) |
$164.08 |
$293 |
1.0× |
| Corpora cavernosography (74445) |
$380.24 |
$679 |
3.8× |
| CT abdomen and pelvis without and with contrast (74178) |
$5,866.56 |
$10,476 |
17.6× |
| CT abdomen and pelvis without contrast (74176) |
$4,512.48 |
$8,058 |
19.8× |
| CT abdomen w contrast (74160) |
$3,053.68 |
$5,453 |
18.2× |
| CT abdomen w wo contrast (74170) |
$3,539.20 |
$6,320 |
21.1× |
| CT abdomen w/o contrast (74150) |
$2,694.16 |
$4,811 |
27.0× |
| CT angio hrt w/3d image (75574) |
$3,567.20 |
$6,370 |
10.7× |
| CT angiography upper extremity lt (73206) |
$2,464 |
$4,400 |
14.7× |
| CT c-spine w/o contrast (72125) |
$1,432.48 |
$2,558 |
14.3× |
| CT cere prfuj alys c+ w/o CT/CTA same anatomy (70473) |
$271.04 |
$484 |
1.6× |
| CT cervical spine w&w/o contrast (72127) |
$2,455.04 |
$4,384 |
14.6× |
| CT cervical spine with contrast (72126) |
$1,677.76 |
$2,996 |
5.0× |
| CT chest w/wo contrast (71270) |
$2,409.12 |
$4,302 |
14.4× |
| CT chest with contrast (71260) |
$2,250.08 |
$4,018 |
13.4× |
| CT colonography screening (74263) |
$1,581.44 |
$2,824 |
6.9× |
| CT colonography w/o cntrst (74261) |
$1,505.84 |
$2,689 |
15.1× |
| CT head/brain with contrast (70460) |
$1,062.32 |
$1,897 |
6.3× |
| CT head/brain without and with contrast (70470) |
$2,614.64 |
$4,669 |
15.6× |
| CT heart contrast eval cardiac structure&morph (75572) |
$2,546.32 |
$4,547 |
7.6× |
| CT heart no contrast quant eval coronry calcium (75571) |
$785.68 |
$1,403 |
9.4× |
| CT hrt w/3d image congen (75573) |
$2,161.04 |
$3,859 |
6.5× |
| CT iac w contrast (70481) |
$1,999.20 |
$3,570 |
11.9× |
| CT limited/localized follow up study (76380) |
$497.84 |
$889 |
6.0× |
| CT lower ext w/o (73700) |
$932.96 |
$1,666 |
9.3× |
| CT lower extremity w wo contrast (73702) |
$1,470.56 |
$2,626 |
8.8× |
| CT lower extremity with contrast (73701) |
$949.20 |
$1,695 |
5.7× |
| CT lumbar spine w & w/o contrast (72133) |
$1,696.80 |
$3,030 |
10.1× |
| CT lumbar spine w/o contrast (72131) |
$1,304.80 |
$2,330 |
13.1× |
| CT lumbar spine with contrast (72132) |
$1,591.52 |
$2,842 |
4.8× |
| CT maxillofacial w contrast (70487) |
$2,057.44 |
$3,674 |
12.3× |
| CT maxillofacial w/o contrast (70486) |
$1,900.08 |
$3,393 |
19.0× |
| CT maxillofacial w/wo contrast (70488) |
$2,152.64 |
$3,844 |
12.8× |
| CT neck soft tissue w contrast (70491) |
$2,473.52 |
$4,417 |
14.8× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$2,134.16 |
$3,811 |
12.7× |
| CT orbits w/o contrast (70480) |
$1,996.40 |
$3,565 |
20.0× |
| CT pelvis w & w/o contrast (72194) |
$2,305.52 |
$4,117 |
13.8× |
| CT pelvis w/o contrast (72192) |
$1,889.44 |
$3,374 |
18.9× |
| CT scan for measuring calcium and other minerals in bone (77078) |
$529.76 |
$946 |
6.4× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,656.08 |
$4,743 |
15.8× |
| CT soft tissue neck w/o contrast (70490) |
$2,345.28 |
$4,188 |
23.5× |
| CT thoracic spine w/contrast (72129) |
$1,933.68 |
$3,453 |
11.5× |
| CT thoracic spine w/o contrast (72128) |
$1,782.48 |
$3,183 |
17.8× |
| CT thoracic spine w/wo contrast (72130) |
$2,139.20 |
$3,820 |
12.8× |
| CT thorax w/o contrast (71250) |
$1,793.12 |
$3,202 |
17.9× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,360.24 |
$2,429 |
8.1× |
| CT upper extremity w/o contrast rt (73200) |
$1,037.12 |
$1,852 |
10.4× |
| CT upper extremity with contrast (73201) |
$1,057.84 |
$1,889 |
3.2× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$933.52 |
$1,667 |
5.6× |
| Cta Abdomen (74175) |
$1,663.20 |
$2,970 |
9.9× |
| CTA abdomen pelvis (74174) |
$4,851.28 |
$8,663 |
14.5× |
| CTA chest (71275) |
$2,491.44 |
$4,449 |
14.9× |
| Cta Head (70496) |
$1,659.28 |
$2,963 |
9.9× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$621.04 |
$1,109 |
1.9× |
| CTA lwr ext w&w/o contrast (73706) |
$2,464 |
$4,400 |
14.7× |
| Cta Neck (70498) |
$2,943.92 |
$5,257 |
17.6× |
| Cta Pelvis (72191) |
$1,134.56 |
$2,026 |
6.8× |
| Cystography minimum 3 views rs&i (74430) |
$521.36 |
$931 |
1.6× |
| Diskogram cervical (72285) |
$622.16 |
$1,111 |
0.3× |
| Diskography lumbar (72295) |
$622.16 |
$1,111 |
0.3× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$266.56 |
$476 |
2.7× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$363.44 |
$649 |
3.6× |
| Dx ophthalmic us ant segment immersion uni/bi (76513) |
$224 |
$400 |
2.2× |
| Dxa bone density study 1/> sites axial skel (77080) |
$545.44 |
$974 |
5.5× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$221.76 |
$396 |
2.7× |
| Dxa bone density study axial skeleton (77085) |
$244.72 |
$437 |
2.4× |
| Echo exam of fetal heart (76825) |
$484.40 |
$865 |
0.9× |
| Echo fetal cardiovasc w/wo m-mode repeat std (76826) |
$315.28 |
$563 |
1.4× |
| Echoencephalography real time imaging (76506) |
$73.36 |
$131 |
0.7× |
| Esophagus (74220) |
$210 |
$375 |
1.3× |
| Fetal biophysical profile non-stress testing (76818) |
$435.68 |
$778 |
4.4× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$178.64 |
$319 |
1.8× |
| Fluoroscopy up to 1 hr (76000) |
$739.20 |
$1,320 |
3.2× |
| Foot 2 views (73620) |
$472.64 |
$844 |
5.7× |
| Forearm 2 views (73090) |
$395.92 |
$707 |
4.8× |
| Full Mouth X-Ray Of Teeth - Xr Teeth Full Mouth (70320) |
$105.28 |
$188 |
0.5× |
| Gated Heart Planar Single (78472) |
$336.56 |
$601 |
0.9× |
| Hand 2 views (73120) |
$385.28 |
$688 |
3.9× |
| Hand 3 views (73130) |
$388.08 |
$693 |
4.7× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$2,761.36 |
$4,931 |
5.3× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$338.24 |
$604 |
0.9× |
| Humerus Min 2 Views Left (73060) |
$327.04 |
$584 |
3.9× |
| Hysterosalpingogram (74740) |
$1,053.92 |
$1,882 |
4.6× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$522.48 |
$933 |
1.0× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$2,256.24 |
$4,029 |
4.3× |
| Knee 3 views (73562) |
$356.16 |
$636 |
4.3× |
| Liver & spleen imaging static only (78215) |
$448.56 |
$801 |
1.2× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$481.60 |
$860 |
1.3× |
| Lung perf&ventilat diferentl (78598) |
$243.04 |
$434 |
0.5× |
| Lymphoscintigraphy (78195) |
$560 |
$1,000 |
1.1× |
| Mammary ductogram or galactogram multiple (77054) |
$269.92 |
$482 |
1.2× |
| Mammary ductogram or galactogram single (77053) |
$240.80 |
$430 |
1.1× |
| Meckels Diverticulum (78290) |
$388.08 |
$693 |
1.0× |
| Mlc imrt design & construction per imrt plan (77338) |
$841.68 |
$1,503 |
2.4× |
| Mr safety determination physician/other qhp (76016) |
$133.28 |
$238 |
1.6× |
| Mr safety implant pos&/immoblj supvj phys/qhp (76019) |
$90.16 |
$161 |
1.6× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$34.72 |
$62 |
1.3× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$138.88 |
$248 |
1.5× |
| Mr safety med physics xm customization plng&mntr (76017) |
$339.92 |
$607 |
1.5× |
| MRA head w & w/o contrast (70546) |
$3,172.96 |
$5,666 |
9.5× |
| MRA head w/o contrast (70544) |
$2,618.56 |
$4,676 |
11.5× |
| MRA head with contrast (70545) |
$2,687.44 |
$4,799 |
8.1× |
| MRA neck w contrast (70548) |
$3,631.60 |
$6,485 |
10.9× |
| Mra Neck W/O &W/Contrast Material (70549) |
$3,747.52 |
$6,692 |
11.2× |
| MRA neck w/o contrast (70547) |
$3,053.12 |
$5,452 |
13.4× |
| MRI abdomen w contrast (74182) |
$3,137.12 |
$5,602 |
9.4× |
| MRI abdomen w/o & w/contrast material (74183) |
$4,037.04 |
$7,209 |
12.1× |
| MRI abdomen w/o contrast (74181) |
$2,335.76 |
$4,171 |
10.2× |
| MRI any jnt lwr ext with con lt (73722) |
$4,989.60 |
$8,910 |
6.7× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$4,435.76 |
$7,921 |
5.9× |
| MRI bone marrow blood supply (77084) |
$1,515.92 |
$2,707 |
6.6× |
| MRI breast w/o contrast bilateral (77047) |
$2,735.60 |
$4,885 |
12.0× |
| MRI breast w/o contrast unilat (77046) |
$2,690.24 |
$4,804 |
11.8× |
| MRI c-spine with contrast (72142) |
$3,463.04 |
$6,184 |
10.4× |
| MRI cardiac w/o contrast (75557) |
$4,403.28 |
$7,863 |
19.3× |
| MRI cervical spine w/o contrast (72141) |
$3,417.68 |
$6,103 |
15.0× |
| MRI chest w/o & w/contrast material (71552) |
$3,670.24 |
$6,554 |
11.0× |
| MRI chest w/o contrast (71550) |
$2,752.40 |
$4,915 |
12.1× |
| MRI chest with contrast (71551) |
$2,898 |
$5,175 |
3.9× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$4,384.80 |
$7,830 |
13.1× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$3,116.96 |
$5,566 |
9.3× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,778.56 |
$3,176 |
7.8× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,566.32 |
$2,797 |
6.9× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,956.64 |
$3,494 |
5.9× |
| MRI orbit/face/neck w/contrast (70542) |
$1,737.12 |
$3,102 |
5.2× |
| MRI pelvis w contrast (72196) |
$2,906.40 |
$5,190 |
8.7× |
| MRI pelvis w/o & w/contrast material (72197) |
$4,063.36 |
$7,256 |
12.2× |
| MRI pelvis w/o contrast (72195) |
$2,271.36 |
$4,056 |
10.0× |
| MRI scan of arm joint before and after contrast (73223) |
$6,048 |
$10,800 |
18.1× |
| MRI scan of leg joint before and after contrast (73723) |
$6,199.20 |
$11,070 |
18.6× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$3,544.24 |
$6,329 |
10.6× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,486.40 |
$4,440 |
7.5× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,714.32 |
$4,847 |
8.1× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$2,642.64 |
$4,719 |
7.9× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$3,957.52 |
$7,067 |
11.9× |
| MRI thoracic spine w/o contrast (72146) |
$2,576.56 |
$4,601 |
11.3× |
| MRI tmj (70336) |
$1,710.24 |
$3,054 |
7.5× |
| MRI upper ext joint w/o contrast (73221) |
$2,457.28 |
$4,388 |
10.8× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$4,687.20 |
$8,370 |
14.1× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,247.68 |
$2,228 |
5.5× |
| Myocardial infarct spect (78469) |
$365.12 |
$652 |
0.7× |
| Myocardial Spect Multiple Studies (78452) |
$720.16 |
$1,286 |
0.6× |
| Myocrd img PET prfuj mlt std rst&strs cncrnt CT (78431) |
$5,103.84 |
$9,114 |
2.4× |
| Neck soft tissue (70360) |
$280 |
$500 |
3.4× |
| Nm gastric emptying study (78264) |
$493.36 |
$881 |
1.3× |
| Nm gastroesophageal reflux study (78262) |
$397.60 |
$710 |
1.0× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$1,109.92 |
$1,982 |
0.8× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$374.64 |
$669 |
3.7× |
| Orthopantogram (70355) |
$64.40 |
$115 |
0.8× |
| Osseous survey infant (77076) |
$180.88 |
$323 |
1.8× |
| Osseous survey limited (77074) |
$206.64 |
$369 |
2.1× |
| Parathyrd planar w/wo subtrj (78071) |
$1,157.52 |
$2,067 |
3.0× |
| Parathyroid imaging (78070) |
$675.36 |
$1,206 |
1.8× |
| Pelvis 1 or 2 views (72170) |
$328.72 |
$587 |
3.3× |
| Perineogram (74775) |
$253.68 |
$453 |
1.1× |
| PET image w/CT, skull-thigh (78815) |
$1,515.36 |
$2,706 |
1.1× |
| PET imaging for CT attenuation whole body (78816) |
$2,638.16 |
$4,711 |
1.9× |
| Pr gi endoscopic ultrasound (76975) |
$514.64 |
$919 |
2.3× |
| Pr heart first pass single,planar (78481) |
$348.88 |
$623 |
0.7× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$3,722.32 |
$6,647 |
11.2× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$397.60 |
$710 |
1.0× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$525.84 |
$939 |
1.0× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$488.88 |
$873 |
0.9× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$334.32 |
$597 |
4.0× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$650.16 |
$1,161 |
6.5× |
| Radex hips bilateral with pelvis 2 views (73521) |
$478.80 |
$855 |
4.8× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$296.80 |
$530 |
3.0× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$1,081.92 |
$1,932 |
10.8× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$656.60 |
$1,172.50 |
1.2× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$398.72 |
$712 |
4.1× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$472.64 |
$844 |
1.3× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$250.88 |
$448 |
2.5× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$324.24 |
$579 |
3.9× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$357.84 |
$639 |
3.6× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$395.36 |
$706 |
4.8× |
| Radiologic exam colon single contrast study (74270) |
$442.96 |
$791 |
2.6× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$214.48 |
$383 |
1.3× |
| Radiologic exam teeth prtl exam < full mouth (70310) |
$96.88 |
$173 |
0.4× |
| Radiologic exam upr gi trc double contrast study (74246) |
$745.92 |
$1,332 |
4.4× |
| Radiologic exam upr gi trc single contrast study (74240) |
$740.32 |
$1,322 |
4.4× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$372.40 |
$665 |
4.5× |
| Radiologic Examination Salivary Gland Calculus (70380) |
$120.96 |
$216 |
1.5× |
| Radiological examination surgical specimen (76098) |
$707.84 |
$1,264 |
1.4× |
| Ribs bilateral 3 views (71110) |
$453.60 |
$810 |
4.5× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$1,259.44 |
$2,249 |
2.4× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,016.40 |
$1,815 |
2.0× |
| Sacroiliac Joints < 3 Views (72200) |
$331.52 |
$592 |
3.3× |
| Scanogram (77073) |
$145.04 |
$259 |
1.5× |
| Scapula complete (73010) |
$217.84 |
$389 |
2.2× |
| Screening digital breast tomosynthesis (77063) |
$70.56 |
$126 |
3.0× |
| Sella turcica (70240) |
$127.12 |
$227 |
1.5× |
| Sialogram (70390) |
$314.72 |
$562 |
1.4× |
| Simulation intermediate (77285) |
$1,113.84 |
$1,989 |
3.1× |
| Small bowel series (74250) |
$553.28 |
$988 |
3.3× |
| Spec medical radj physics consltj (77370) |
$519.12 |
$927 |
4.0× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$582.96 |
$1,041 |
1.6× |
| Special dosimetry (77331) |
$351.68 |
$628 |
2.7× |
| Special treatment procedure (77470) |
$514.64 |
$919 |
1.0× |
| Speech evaluation complex (70371) |
$256.48 |
$458 |
1.1× |
| Spine thoracic 3 views (72072) |
$497.84 |
$889 |
5.0× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$1,082.48 |
$1,933 |
3.0× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$556.08 |
$993 |
1.6× |
| Temporomandble Jt Arthrography Rs&I (70332) |
$644 |
$1,150 |
2.8× |
| Testicular Imaging With Vascular Flow (78761) |
$466.48 |
$833 |
1.2× |
| Ther rad simulaj-aided field setting complex (77290) |
$2,728.88 |
$4,873 |
7.6× |
| Ther rad simulaj-aided field setting simple (77280) |
$735.84 |
$1,314 |
5.7× |
| Therapeutic Enema (74283) |
$913.92 |
$1,632 |
5.5× |
| Thoracolumbar 2 views (72080) |
$208.32 |
$372 |
2.5× |
| Thyroid Imaging With Vascular Flow (78013) |
$385.84 |
$689 |
1.0× |
| Thyroid uptake measurement (78012) |
$325.36 |
$581 |
0.9× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$389.76 |
$696 |
1.0× |
| Tmj unilateral (70328) |
$185.36 |
$331 |
2.2× |
| Tomogram (76100) |
$221.76 |
$396 |
2.2× |
| Treatment device intermediate (77333) |
$871.92 |
$1,557 |
6.8× |
| Treatment devices simple (77332) |
$809.76 |
$1,446 |
6.3× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$1,512 |
$2,700 |
2.9× |
| Tx devices design & construction complex (77334) |
$1,603.84 |
$2,864 |
4.5× |
| Ultrasound, abdomen limited (76705) |
$1,253.84 |
$2,239 |
12.5× |
| Unlisted magnetic resonance procedure (76498) |
$134.40 |
$240 |
1.6× |
| Unlisted Ultrasound Procedure (76999) |
$456.40 |
$815 |
5.5× |
| Upper Extremity Infant (73092) |
$138.88 |
$248 |
1.4× |
| Urethrocystography retrograde rs&i (74450) |
$527.52 |
$942 |
2.3× |
| Urethrocystography voiding (74455) |
$583.52 |
$1,042 |
2.6× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$915.04 |
$1,634 |
5.5× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$455.28 |
$813 |
2.7× |
| Us abdl aorta screen aaa (76706) |
$124.88 |
$223 |
1.2× |
| Us breast unilateral complete (76641) |
$985.04 |
$1,759 |
9.9× |
| Us breast unilateral limited (76642) |
$979.44 |
$1,749 |
11.8× |
| Us chest (76604) |
$726.88 |
$1,298 |
7.3× |
| Us compl joint r-t w/image documentation (76881) |
$114.24 |
$204 |
1.1× |
| Us guided compression repair (76936) |
$241.36 |
$431 |
1.2× |
| Us infant hips dynamic (76885) |
$448.56 |
$801 |
5.4× |
| Us kidney transplant (76776) |
$102.48 |
$183 |
1.0× |
| Us ob transvaginal (76817) |
$1,934.24 |
$3,454 |
19.4× |
| Us pelvic non ob complete (76856) |
$2,419.76 |
$4,321 |
24.2× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$618.80 |
$1,105 |
6.2× |
| Us pregnancy ltd (76815) |
$680.40 |
$1,215 |
6.8× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$1,864.24 |
$3,329 |
18.7× |
| Us retroperitoneal complete (76770) |
$337.12 |
$602 |
3.4× |
| Us retroperitoneal limited (76775) |
$465.36 |
$831 |
4.7× |
| Us scrotum and contents (76870) |
$1,162 |
$2,075 |
11.6× |
| Us soft tissue head/neck (76536) |
$1,089.76 |
$1,946 |
10.9× |
| Us spinal canal and contents (76800) |
$863.52 |
$1,542 |
8.6× |
| Us xtr non-vasc lmtd (76882) |
$174.16 |
$311 |
1.7× |
| Venogram extremity bilateral (75822) |
$1,314.88 |
$2,348 |
0.9× |
| Venography extremity unilateral rs&i (75820) |
$656.88 |
$1,173 |
0.4× |
| Wrist 2 views (73100) |
$422.24 |
$754 |
5.1× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$593.60 |
$1,060 |
5.9× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$77.84 |
$139 |
0.9× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$491.68 |
$878 |
5.9× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$1,098.16 |
$1,961 |
6.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$390.88 |
$698 |
4.7× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$467.60 |
$835 |
5.6× |
| X-ray exam entire spi 4/5 vw (72083) |
$868 |
$1,550 |
8.7× |
| X-ray exam hip uni 1 view (73501) |
$284.48 |
$508 |
3.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$292.32 |
$522 |
3.5× |
| X-ray exam hip uni 4/> views (73503) |
$355.60 |
$635 |
3.6× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$857.36 |
$1,531 |
8.6× |
| X-ray exam of femur 1 (73551) |
$53.20 |
$95 |
0.6× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$630.56 |
$1,126 |
3.8× |
| X-ray eye for foreign body (70030) |
$87.92 |
$157 |
1.1× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$252.56 |
$451 |
2.5× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$119.28 |
$213 |
1.4× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$529.20 |
$945 |
6.4× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$395.92 |
$707 |
0.2× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$398.72 |
$712 |
4.8× |
| X-ray IV pyelogram+drip infusn (74410) |
$373.52 |
$667 |
2.2× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$112 |
$200 |
1.3× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$364.56 |
$651 |
3.6× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$233.52 |
$417 |
2.8× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$96.88 |
$173 |
1.2× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$496.16 |
$886 |
5.0× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$758.80 |
$1,355 |
7.6× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$601.44 |
$1,074 |
6.0× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$545.16 |
$973.50 |
6.6× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$306.88 |
$548 |
3.1× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$459.76 |
$821 |
4.6× |
| X-Ray Renal Cyst Xlumbar+Contrst - Xr Renal Cyst Lumbar W Contrast (74470) |
$506.24 |
$904 |
1.0× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$969.92 |
$1,732 |
2.9× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$439.60 |
$785 |
5.3× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$559.44 |
$999 |
5.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$563.92 |
$1,007 |
5.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$479.36 |
$856 |
4.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$380.80 |
$680 |
4.6× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$420.56 |
$751 |
5.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$911.12 |
$1,627 |
11.0× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$376.88 |
$673 |
4.5× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$120.40 |
$215 |
1.2× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$104.16 |
$186 |
1.0× |
| X-Ray Spine One View - Xr Spine (72020) |
$240.24 |
$429 |
2.9× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$506.80 |
$905 |
6.1× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$155.68 |
$278 |
1.9× |
| X-Ray Teeth Single - Xr Teeth 1 View (70300) |
$85.68 |
$153 |
1.0× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$477.12 |
$852 |
4.8× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$964.32 |
$1,722 |
9.6× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$271.04 |
$484 |
3.3× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$427.84 |
$764 |
5.1× |
| Xr arthrogram ankle (73615) |
$388.08 |
$693 |
1.2× |
| Xr c-spine 6 or more views (72052) |
$746.48 |
$1,333 |
7.5× |
| Xr chest 4+ views (71048) |
$412.72 |
$737 |
4.1× |
| Xr Cholecystography Oral Contrast (74290) |
$253.68 |
$453 |
1.5× |
| Xr finger(s) 2+ views (73140) |
$224.56 |
$401 |
2.7× |
| Xr internal auditory meati complete (70134) |
$129.36 |
$231 |
0.2× |
| XR Mastoids < 3 Views Bilateral (70120) |
$55.44 |
$99 |
0.6× |
| Xr myelogram posterior fossa (70010) |
$632.80 |
$1,130 |
1.9× |
| Xr optic foramina (70190) |
$127.12 |
$227 |
1.5× |
| Xr shoulder 1 view (73020) |
$314.16 |
$561 |
3.8× |
| Xr spine cervical 4 or 5 views (72050) |
$713.44 |
$1,274 |
7.1× |
| Xr tibia/fibula 2 views (73590) |
$364.56 |
$651 |
4.4× |
| Xr tmj bilateral (70330) |
$370.16 |
$661 |
4.5× |
| Xray knee 1 or 2 views rt (73560) |
$268.24 |
$479 |
3.2× |